US7622505B2 - Association between agomelatine and a noradrenaline reuptake inhibitor, and pharmaceutical compositions containing it - Google Patents
Association between agomelatine and a noradrenaline reuptake inhibitor, and pharmaceutical compositions containing it Download PDFInfo
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- US7622505B2 US7622505B2 US11/516,877 US51687706A US7622505B2 US 7622505 B2 US7622505 B2 US 7622505B2 US 51687706 A US51687706 A US 51687706A US 7622505 B2 US7622505 B2 US 7622505B2
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- United States
- Prior art keywords
- agomelatine
- association
- reuptake inhibitor
- noradrenaline reuptake
- composition
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- YJYPHIXNFHFHND-UHFFFAOYSA-N agomelatine Chemical compound C1=CC=C(CCNC(C)=O)C2=CC(OC)=CC=C21 YJYPHIXNFHFHND-UHFFFAOYSA-N 0.000 title claims abstract description 22
- 229960002629 agomelatine Drugs 0.000 title claims abstract description 16
- 239000008194 pharmaceutical composition Substances 0.000 title claims description 8
- 239000002767 noradrenalin uptake inhibitor Substances 0.000 title abstract description 11
- 229940126569 noradrenaline reuptake inhibitor Drugs 0.000 title abstract description 11
- 208000019022 Mood disease Diseases 0.000 claims abstract description 5
- 208000020401 Depressive disease Diseases 0.000 claims description 6
- 208000024714 major depressive disease Diseases 0.000 claims description 6
- 208000019901 Anxiety disease Diseases 0.000 claims description 5
- 239000002253 acid Substances 0.000 claims description 5
- 230000036506 anxiety Effects 0.000 claims description 5
- 229960003770 reboxetine Drugs 0.000 claims description 5
- 150000003839 salts Chemical class 0.000 claims description 5
- 208000012672 seasonal affective disease Diseases 0.000 claims description 5
- 208000019116 sleep disease Diseases 0.000 claims description 5
- 239000000203 mixture Substances 0.000 claims description 4
- CBQGYUDMJHNJBX-RTBURBONSA-N reboxetine Chemical compound CCOC1=CC=CC=C1O[C@H](C=1C=CC=CC=1)[C@@H]1OCCNC1 CBQGYUDMJHNJBX-RTBURBONSA-N 0.000 claims description 4
- 239000000546 pharmaceutical excipient Substances 0.000 claims description 3
- 239000004480 active ingredient Substances 0.000 claims description 2
- 230000003389 potentiating effect Effects 0.000 claims description 2
- 241001465754 Metazoa Species 0.000 claims 2
- 239000003795 chemical substances by application Substances 0.000 abstract description 11
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- SFLSHLFXELFNJZ-QMMMGPOBSA-N (-)-norepinephrine Chemical compound NC[C@H](O)C1=CC=C(O)C(O)=C1 SFLSHLFXELFNJZ-QMMMGPOBSA-N 0.000 description 4
- 150000004677 hydrates Chemical class 0.000 description 4
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- SFLSHLFXELFNJZ-UHFFFAOYSA-N norepinephrine Natural products NCC(O)C1=CC=C(O)C(O)=C1 SFLSHLFXELFNJZ-UHFFFAOYSA-N 0.000 description 4
- PEDCQBHIVMGVHV-UHFFFAOYSA-N Glycerine Chemical compound OCC(O)CO PEDCQBHIVMGVHV-UHFFFAOYSA-N 0.000 description 3
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- DPXJVFZANSGRMM-UHFFFAOYSA-N acetic acid;2,3,4,5,6-pentahydroxyhexanal;sodium Chemical compound [Na].CC(O)=O.OCC(O)C(O)C(O)C(O)C=O DPXJVFZANSGRMM-UHFFFAOYSA-N 0.000 description 2
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- QIQXTHQIDYTFRH-UHFFFAOYSA-N octadecanoic acid Chemical compound CCCCCCCCCCCCCCCCCC(O)=O QIQXTHQIDYTFRH-UHFFFAOYSA-N 0.000 description 2
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- GUBGYTABKSRVRQ-XLOQQCSPSA-N Alpha-Lactose Chemical compound O[C@@H]1[C@@H](O)[C@@H](O)[C@@H](CO)O[C@H]1O[C@@H]1[C@@H](CO)O[C@H](O)[C@H](O)[C@H]1O GUBGYTABKSRVRQ-XLOQQCSPSA-N 0.000 description 1
- WSVLPVUVIUVCRA-KPKNDVKVSA-N Alpha-lactose monohydrate Chemical compound O.O[C@@H]1[C@@H](O)[C@@H](O)[C@@H](CO)O[C@H]1O[C@@H]1[C@@H](CO)O[C@H](O)[C@H](O)[C@H]1O WSVLPVUVIUVCRA-KPKNDVKVSA-N 0.000 description 1
- 239000005995 Aluminium silicate Substances 0.000 description 1
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- 241000416162 Astragalus gummifer Species 0.000 description 1
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- FBPFZTCFMRRESA-FSIIMWSLSA-N D-Glucitol Natural products OC[C@H](O)[C@H](O)[C@@H](O)[C@H](O)CO FBPFZTCFMRRESA-FSIIMWSLSA-N 0.000 description 1
- FBPFZTCFMRRESA-KVTDHHQDSA-N D-Mannitol Chemical compound OC[C@@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-KVTDHHQDSA-N 0.000 description 1
- FBPFZTCFMRRESA-JGWLITMVSA-N D-glucitol Chemical compound OC[C@H](O)[C@@H](O)[C@H](O)[C@H](O)CO FBPFZTCFMRRESA-JGWLITMVSA-N 0.000 description 1
- HCYAFALTSJYZDH-UHFFFAOYSA-N Desimpramine Chemical compound C1CC2=CC=CC=C2N(CCCNC)C2=CC=CC=C21 HCYAFALTSJYZDH-UHFFFAOYSA-N 0.000 description 1
- 208000019454 Feeding and Eating disease Diseases 0.000 description 1
- 108010010803 Gelatin Proteins 0.000 description 1
- WQZGKKKJIJFFOK-GASJEMHNSA-N Glucose Natural products OC[C@H]1OC(O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-GASJEMHNSA-N 0.000 description 1
- 208000001456 Jet Lag Syndrome Diseases 0.000 description 1
- GUBGYTABKSRVRQ-QKKXKWKRSA-N Lactose Natural products OC[C@H]1O[C@@H](O[C@H]2[C@H](O)[C@@H](O)C(O)O[C@@H]2CO)[C@H](O)[C@@H](O)[C@H]1O GUBGYTABKSRVRQ-QKKXKWKRSA-N 0.000 description 1
- WHXSMMKQMYFTQS-UHFFFAOYSA-N Lithium Chemical compound [Li] WHXSMMKQMYFTQS-UHFFFAOYSA-N 0.000 description 1
- FYYHWMGAXLPEAU-UHFFFAOYSA-N Magnesium Chemical compound [Mg] FYYHWMGAXLPEAU-UHFFFAOYSA-N 0.000 description 1
- 229930195725 Mannitol Natural products 0.000 description 1
- WHNWPMSKXPGLAX-UHFFFAOYSA-N N-Vinyl-2-pyrrolidone Chemical compound C=CN1CCCC1=O WHNWPMSKXPGLAX-UHFFFAOYSA-N 0.000 description 1
- 208000008589 Obesity Diseases 0.000 description 1
- 239000002202 Polyethylene glycol Substances 0.000 description 1
- 208000013738 Sleep Initiation and Maintenance disease Diseases 0.000 description 1
- 229920002472 Starch Polymers 0.000 description 1
- CZMRCDWAGMRECN-UGDNZRGBSA-N Sucrose Chemical compound O[C@H]1[C@H](O)[C@@H](CO)O[C@@]1(CO)O[C@@H]1[C@H](O)[C@@H](O)[C@H](O)[C@@H](CO)O1 CZMRCDWAGMRECN-UGDNZRGBSA-N 0.000 description 1
- 229930006000 Sucrose Natural products 0.000 description 1
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- 239000002250 absorbent Substances 0.000 description 1
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- 239000000556 agonist Substances 0.000 description 1
- 239000000783 alginic acid Substances 0.000 description 1
- 235000010443 alginic acid Nutrition 0.000 description 1
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- 150000004781 alginic acids Chemical class 0.000 description 1
- XAGFODPZIPBFFR-UHFFFAOYSA-N aluminium Chemical compound [Al] XAGFODPZIPBFFR-UHFFFAOYSA-N 0.000 description 1
- 235000012211 aluminium silicate Nutrition 0.000 description 1
- 229910000323 aluminium silicate Inorganic materials 0.000 description 1
- 239000005557 antagonist Substances 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- WQZGKKKJIJFFOK-VFUOTHLCSA-N beta-D-glucose Chemical compound OC[C@H]1O[C@@H](O)[C@H](O)[C@@H](O)[C@@H]1O WQZGKKKJIJFFOK-VFUOTHLCSA-N 0.000 description 1
- 159000000007 calcium salts Chemical class 0.000 description 1
- 239000001768 carboxy methyl cellulose Substances 0.000 description 1
- 239000000969 carrier Substances 0.000 description 1
- 239000001913 cellulose Substances 0.000 description 1
- 229920002678 cellulose Polymers 0.000 description 1
- 239000008119 colloidal silica Substances 0.000 description 1
- -1 colourants Substances 0.000 description 1
- 239000006071 cream Substances 0.000 description 1
- 230000001419 dependent effect Effects 0.000 description 1
- 229960003914 desipramine Drugs 0.000 description 1
- 239000008121 dextrose Substances 0.000 description 1
- 210000002249 digestive system Anatomy 0.000 description 1
- FSBVERYRVPGNGG-UHFFFAOYSA-N dimagnesium dioxido-bis[[oxido(oxo)silyl]oxy]silane hydrate Chemical compound O.[Mg+2].[Mg+2].[O-][Si](=O)O[Si]([O-])([O-])O[Si]([O-])=O FSBVERYRVPGNGG-UHFFFAOYSA-N 0.000 description 1
- 239000007884 disintegrant Substances 0.000 description 1
- 239000008298 dragée Substances 0.000 description 1
- 239000003814 drug Substances 0.000 description 1
- 230000002526 effect on cardiovascular system Effects 0.000 description 1
- 230000002500 effect on skin Effects 0.000 description 1
- 235000003599 food sweetener Nutrition 0.000 description 1
- 239000000499 gel Substances 0.000 description 1
- 239000008273 gelatin Substances 0.000 description 1
- 229920000159 gelatin Polymers 0.000 description 1
- 239000007903 gelatin capsule Substances 0.000 description 1
- 235000019322 gelatine Nutrition 0.000 description 1
- 235000011852 gelatine desserts Nutrition 0.000 description 1
- 206010022437 insomnia Diseases 0.000 description 1
- 208000033915 jet lag type circadian rhythm sleep disease Diseases 0.000 description 1
- 239000008101 lactose Substances 0.000 description 1
- 229960001375 lactose Drugs 0.000 description 1
- 229960001021 lactose monohydrate Drugs 0.000 description 1
- 229910052744 lithium Inorganic materials 0.000 description 1
- 239000007937 lozenge Substances 0.000 description 1
- 239000011777 magnesium Substances 0.000 description 1
- 229910052749 magnesium Inorganic materials 0.000 description 1
- 239000000391 magnesium silicate Substances 0.000 description 1
- 235000019792 magnesium silicate Nutrition 0.000 description 1
- 229910052919 magnesium silicate Inorganic materials 0.000 description 1
- 235000019359 magnesium stearate Nutrition 0.000 description 1
- 239000000594 mannitol Substances 0.000 description 1
- 235000010355 mannitol Nutrition 0.000 description 1
- 230000007246 mechanism Effects 0.000 description 1
- 230000001193 melatoninergic effect Effects 0.000 description 1
- 229920000609 methyl cellulose Polymers 0.000 description 1
- 239000001923 methylcellulose Substances 0.000 description 1
- 235000010981 methylcellulose Nutrition 0.000 description 1
- 229960002900 methylcellulose Drugs 0.000 description 1
- 229940127237 mood stabilizer Drugs 0.000 description 1
- 230000001722 neurochemical effect Effects 0.000 description 1
- 235000020824 obesity Nutrition 0.000 description 1
- 239000002674 ointment Substances 0.000 description 1
- 229940053544 other antidepressants in atc Drugs 0.000 description 1
- 230000001575 pathological effect Effects 0.000 description 1
- 239000000902 placebo Substances 0.000 description 1
- 229940068196 placebo Drugs 0.000 description 1
- 229920001223 polyethylene glycol Polymers 0.000 description 1
- 239000001267 polyvinylpyrrolidone Substances 0.000 description 1
- 230000008092 positive effect Effects 0.000 description 1
- 229940069328 povidone Drugs 0.000 description 1
- 230000004044 response Effects 0.000 description 1
- 239000000377 silicon dioxide Substances 0.000 description 1
- 235000019812 sodium carboxymethyl cellulose Nutrition 0.000 description 1
- 229920001027 sodium carboxymethylcellulose Polymers 0.000 description 1
- 159000000000 sodium salts Chemical class 0.000 description 1
- 239000000600 sorbitol Substances 0.000 description 1
- 239000008107 starch Substances 0.000 description 1
- 235000019698 starch Nutrition 0.000 description 1
- 239000006190 sub-lingual tablet Substances 0.000 description 1
- 239000005720 sucrose Substances 0.000 description 1
- 239000000829 suppository Substances 0.000 description 1
- 239000003765 sweetening agent Substances 0.000 description 1
- 239000000454 talc Substances 0.000 description 1
- 229910052623 talc Inorganic materials 0.000 description 1
- 239000000196 tragacanth Substances 0.000 description 1
- 235000010487 tragacanth Nutrition 0.000 description 1
- 229940116362 tragacanth Drugs 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/16—Amides, e.g. hydroxamic acids
- A61K31/165—Amides, e.g. hydroxamic acids having aromatic rings, e.g. colchicine, atenolol, progabide
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
- A61K31/00—Medicinal preparations containing organic active ingredients
- A61K31/33—Heterocyclic compounds
- A61K31/395—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins
- A61K31/535—Heterocyclic compounds having nitrogen as a ring hetero atom, e.g. guanethidine or rifamycins having six-membered rings with at least one nitrogen and one oxygen as the ring hetero atoms, e.g. 1,2-oxazines
- A61K31/5375—1,4-Oxazines, e.g. morpholine
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P17/00—Drugs for dermatological disorders
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/18—Antipsychotics, i.e. neuroleptics; Drugs for mania or schizophrenia
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/20—Hypnotics; Sedatives
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/22—Anxiolytics
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P25/00—Drugs for disorders of the nervous system
- A61P25/24—Antidepressants
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P35/00—Antineoplastic agents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
- A61P43/00—Drugs for specific purposes, not provided for in groups A61P1/00-A61P41/00
Definitions
- the present invention relates to a new association between agomelatine, or N-[2-(7-methoxy-1-naphthyl)ethyl]acetamide of formula (I):
- noradrenaline reuptake inhibitor agent or any agent capable of increasing the concentration of noradrenaline at the extracellular level, for obtaining pharmaceutical compositions useful in the treatment of depression and, more especially, in the treatment of resistant depressions.
- Agomelatine or N-[2-(7-methoxy-1-naphthyl)ethyl]acetamide, has the double characteristic of being, on the one hand, an agonist of receptors of the melatoninergic system and, on the other hand, an antagonist of the 5-HT 2c receptor. These properties provide it with activity in the central nervous system and, more especially, in the treatment of major depression, seasonal affective disorder, sleep disorders, cardiovascular pathologies, pathologies of the digestive system, insomnia and fatigue due to jet-lag, and appetite disorders and obesity.
- agomelatine or N-[2-(7-methoxy-l-naphthyl)ethyl]-acetamide or its hydrates, crystalline forms and addition salts with a pharmaceutically acceptable acid or base, used in association with a noradrenaline reuptake inhibitor agent, has valuable properties allowing its use in the treatment of major depressive disorder, seasonal affective disorder and, more especially, in the treatment of resistant depressions, and also in the treatment of psychiatric co-morbidity associated with mood disorder anxiety, panic, stress, sleep disorders . . .
- disorders of the central nervous system such as depression and anxiety, affect a large number of people of all ages. Although many effective molecules exist in that field, none of them allows those various pathological states to be fully cured and some of them have significant side effects. Accordingly, the development of new alternative treatments is ongoing and continues to be a necessity. This is especially true in the case of patients who are totally resistant to all treatments.
- a conventional so-called “strategy of association” consists of combining a plurality of treatments having different mechanisms of action in order to obtain a positive effect. As a general rule, the beneficial effect observed is patient-dependent and arises from the response to one or another of the compounds of the association.
- agomelatine is potentiated by noradrenaline reuptake inhibitor agents, or by agents capable of increasing the concentrations of noradrenaline at the extracellular level. Those agents have the characteristic of potentiating the effects of agomelatine.
- That unpredictable effect allows the use of the association to be considered in the treatment of major depressive disorder, seasonal affective disorders and, more especially, in the treatment of resistant depressions, as well as of psychiatric co-morbidity associated with mood disorder: anxiety, panic, stress, and sleep disorders. Even more especially, that potentiation of the effects will allow the use of the association according to the invention in the treatment of patients resistant to all treatments.
- noradrenaline reuptake inhibitor agents there may be mentioned, more especially and without implying any limitation, reboxetine and desipramine.
- the noradrenaline reuptake inhibitor agent preferred according to the invention is reboxetine.
- the invention accordingly relates to the use of the association between agomelatine or its hydrates, crystalline forms and addition salts with a pharmaceutically acceptable acid or base, and a noradrenaline reuptake inhibitor compound or a compound capable of increasing the concentration of noradrenaline at the extracellular level in obtaining pharmaceutical compositions intended for the treatment of major depressive disorder, seasonal affective disorder and, more especially, resistant depressions, as well as in the treatment of psychiatric co-morbidity associated with mood disorder: anxiety, panic, stress, and sleep disorders.
- the invention relates also to pharmaceutical compositions comprising the association between agomelatine or its hydrates, crystalline forms and addition salts with a pharmaceutically acceptable acid or base, and a noradrenaline reuptake inhibitor compound or a compound capable of increasing the concentration of noradrenaline at the extracellular level in combination with one or more pharmaceutically acceptable excipients.
- compositions according to the invention there may be mentioned, more especially, those which are suitable for oral, parenteral or nasal administration, tablets or dragées, sublingual tablets, gelatin capsules, lozenges, suppositories, creams, ointments, dermal gels etc.
- the pharmaceutical compositions according to the invention comprise one or more excipients or carriers selected from diluents, lubricants, binders, disintegration agents, absorbents, colourants, sweeteners etc.
- the useful dosage varies according to the sex, age and weight of the patient, the administration route, the nature of the disorder and any associated treatments and ranges from 1 mg to 50 mg of agomelatine per 24 hours and is more preferably 25 mg per day.
- the dose of the noradrenaline reuptake inhibitor agent will be less than that used when it is administered on its own.
- N-[2-(7-methoxy-1-naphthyl)ethyl]acetamide 25 g Lactose monohydrate 62 g Magnesium stearate 1.3 g Povidone 9 g Anhydrous colloidal silica 0.3 g Cellulose sodium glycolate 30 g Stearic acid 2.6 g Clinical Study:
- the clinical study is carried out in patients having major depressive disorder treated either with agomelatine and placebo or with agomelatine and reboxetine for a duration of 6 weeks.
- the diagnostic system used is that of DSM-IV; the principal criterion of efficacy is the total score of the Hamilton Rating Scale for Depression.
- a compilation of undesirable events is carried out.
- the study demonstrates a superior activity of the agomelatine-reboxetine association compared with agomelatine alone.
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- Health & Medical Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Chemical & Material Sciences (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Medicinal Chemistry (AREA)
- General Health & Medical Sciences (AREA)
- Pharmacology & Pharmacy (AREA)
- Life Sciences & Earth Sciences (AREA)
- Organic Chemistry (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Chemical & Material Sciences (AREA)
- Chemical Kinetics & Catalysis (AREA)
- Engineering & Computer Science (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Epidemiology (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Neurosurgery (AREA)
- Psychiatry (AREA)
- Anesthesiology (AREA)
- Dermatology (AREA)
- Pain & Pain Management (AREA)
- Acyclic And Carbocyclic Compounds In Medicinal Compositions (AREA)
- Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
- Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
Abstract
Association comprising agomelatine, or N-[2-(7-methoxy-1-naphthyl)ethyl]acetamide, in association with a noradrenaline reuptake inhibitor agent.
Medicinal products containing the same which are useful in treating conditions associated with mood disorders.
Description
The present invention relates to a new association between agomelatine, or N-[2-(7-methoxy-1-naphthyl)ethyl]acetamide of formula (I):
or its hydrates, crystalline forms and addition salts with a pharmaceutically acceptable acid or base, and a noradrenaline reuptake inhibitor agent or any agent capable of increasing the concentration of noradrenaline at the extracellular level, for obtaining pharmaceutical compositions useful in the treatment of depression and, more especially, in the treatment of resistant depressions.
Agomelatine, or N-[2-(7-methoxy-1-naphthyl)ethyl]acetamide, has the double characteristic of being, on the one hand, an agonist of receptors of the melatoninergic system and, on the other hand, an antagonist of the 5-HT2c receptor. These properties provide it with activity in the central nervous system and, more especially, in the treatment of major depression, seasonal affective disorder, sleep disorders, cardiovascular pathologies, pathologies of the digestive system, insomnia and fatigue due to jet-lag, and appetite disorders and obesity.
Agomelatine, its preparation and its use in therapeutics have been described in European Patent Specification EP 0 447 285.
The Applicant has now found that agomelatine, or N-[2-(7-methoxy-l-naphthyl)ethyl]-acetamide or its hydrates, crystalline forms and addition salts with a pharmaceutically acceptable acid or base, used in association with a noradrenaline reuptake inhibitor agent, has valuable properties allowing its use in the treatment of major depressive disorder, seasonal affective disorder and, more especially, in the treatment of resistant depressions, and also in the treatment of psychiatric co-morbidity associated with mood disorder anxiety, panic, stress, sleep disorders . . .
Disorders of the central nervous system, such as depression and anxiety, affect a large number of people of all ages. Although many effective molecules exist in that field, none of them allows those various pathological states to be fully cured and some of them have significant side effects. Accordingly, the development of new alternative treatments is ongoing and continues to be a necessity. This is especially true in the case of patients who are totally resistant to all treatments. A conventional so-called “strategy of association” consists of combining a plurality of treatments having different mechanisms of action in order to obtain a positive effect. As a general rule, the beneficial effect observed is patient-dependent and arises from the response to one or another of the compounds of the association.
The most conventional associations described in the literature are concerned with associations with mood stabilisers, such as lithium, with other antidepressants either of different clinical profile or of different neurochemical profile.
The Applicant has now discovered, surprisingly, that the effects of agomelatine are potentiated by noradrenaline reuptake inhibitor agents, or by agents capable of increasing the concentrations of noradrenaline at the extracellular level. Those agents have the characteristic of potentiating the effects of agomelatine.
That unpredictable effect allows the use of the association to be considered in the treatment of major depressive disorder, seasonal affective disorders and, more especially, in the treatment of resistant depressions, as well as of psychiatric co-morbidity associated with mood disorder: anxiety, panic, stress, and sleep disorders. Even more especially, that potentiation of the effects will allow the use of the association according to the invention in the treatment of patients resistant to all treatments.
Among the noradrenaline reuptake inhibitor agents according to the invention there may be mentioned, more especially and without implying any limitation, reboxetine and desipramine.
The noradrenaline reuptake inhibitor agent preferred according to the invention is reboxetine.
The invention accordingly relates to the use of the association between agomelatine or its hydrates, crystalline forms and addition salts with a pharmaceutically acceptable acid or base, and a noradrenaline reuptake inhibitor compound or a compound capable of increasing the concentration of noradrenaline at the extracellular level in obtaining pharmaceutical compositions intended for the treatment of major depressive disorder, seasonal affective disorder and, more especially, resistant depressions, as well as in the treatment of psychiatric co-morbidity associated with mood disorder: anxiety, panic, stress, and sleep disorders.
The invention relates also to pharmaceutical compositions comprising the association between agomelatine or its hydrates, crystalline forms and addition salts with a pharmaceutically acceptable acid or base, and a noradrenaline reuptake inhibitor compound or a compound capable of increasing the concentration of noradrenaline at the extracellular level in combination with one or more pharmaceutically acceptable excipients.
Among the pharmaceutical compositions according to the invention there may be mentioned, more especially, those which are suitable for oral, parenteral or nasal administration, tablets or dragées, sublingual tablets, gelatin capsules, lozenges, suppositories, creams, ointments, dermal gels etc.
Besides agomelatine and the noradrenaline reuptake inhibitor compound, the pharmaceutical compositions according to the invention comprise one or more excipients or carriers selected from diluents, lubricants, binders, disintegration agents, absorbents, colourants, sweeteners etc.
By way of example, and without implying any limitation, there may be mentioned:
-
- as diluents: lactose, dextrose, sucrose, mannitol, sorbitol, cellulose, glycerol,
- as lubricants silica, talc, stearic acid and its magnesium and calcium salts, polyethylene glycol,
- as binders: aluminium and magnesium silicate, starch, gelatin, tragacanth, methyl-cellulose, sodium carboxymethylcellulose and polyvinylpyrrolidone,
- as disintegrants: agar, alginic acid and its sodium salt, effervescent mixtures.
The useful dosage varies according to the sex, age and weight of the patient, the administration route, the nature of the disorder and any associated treatments and ranges from 1 mg to 50 mg of agomelatine per 24 hours and is more preferably 25 mg per day. The dose of the noradrenaline reuptake inhibitor agent will be less than that used when it is administered on its own.
Pharmaceutical Composition:
Formula for the preparation of 1000 tablets each containing 25 mg of active ingredient:
| N-[2-(7-methoxy-1-naphthyl)ethyl]acetamide | 25 | g | ||
| Lactose monohydrate | 62 | g | ||
| Magnesium stearate | 1.3 | g | ||
| Povidone | 9 | g | ||
| Anhydrous colloidal silica | 0.3 | g | ||
| Cellulose sodium glycolate | 30 | g | ||
| Stearic acid | 2.6 | g | ||
Clinical Study:
The clinical study is carried out in patients having major depressive disorder treated either with agomelatine and placebo or with agomelatine and reboxetine for a duration of 6 weeks. The diagnostic system used is that of DSM-IV; the principal criterion of efficacy is the total score of the Hamilton Rating Scale for Depression. A compilation of undesirable events is carried out. The study demonstrates a superior activity of the agomelatine-reboxetine association compared with agomelatine alone.
Claims (3)
1. A composition comprising a combination of agomelatine, or N-[2-(7-methoxy-1-naphthyl)ethyl]acetamide or crystalline forms and addition salts thereof with a pharmaceutically acceptable acid or base, and reboxetine, wherein the combination results in a potentiating effect.
2. A pharmaceutical composition comprising as active ingredient a composition of claim 1 alone or in combination with one or more pharmaceutically acceptable excipients.
3. A method for treating a living animal body, including a human afflicted with a condition selected from the group consisting of major depressive disorder, seasonal affective disorder, resistant depressions, and psychiatric co-morbidity associated with mood disorder: anxiety, panic, stress, sleep disorders comprising the step of administering to the living animal body, including a human, an amount of the composition of claim 1 which potentiates alleviation of the condition.
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| FR05.09206 | 2005-09-09 | ||
| FR0509206A FR2890564B1 (en) | 2005-09-09 | 2005-09-09 | NOVEL ASSOCIATION BETWEEN AGOMELATIN AND AN INHIBITOR OF NORADRENALINE RECAPTURE AND THE PHARMACEUTICAL COMPOSITIONS CONTAINING IT |
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| US20070060654A1 US20070060654A1 (en) | 2007-03-15 |
| US7622505B2 true US7622505B2 (en) | 2009-11-24 |
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| CA2685924A1 (en) * | 2007-05-01 | 2008-11-13 | Concert Pharmaceuticals Inc. | Naphthyl(ethyl)acetamides |
| WO2008141033A1 (en) * | 2007-05-08 | 2008-11-20 | Auspex Pharmaceuticals Inc. | Substituted naphthalenes |
| CN102342924A (en) * | 2010-08-05 | 2012-02-08 | 北京本草天源药物研究院 | Medicine composition containing agomelatine |
Citations (2)
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| US6096742A (en) * | 1997-07-02 | 2000-08-01 | Merck & Co., Inc. | Polymorphic form of a tachykinin receptor antagonist |
| WO2005002562A1 (en) | 2003-07-04 | 2005-01-13 | H. Lundbeck A/S | The combination of a serotonin reuptake inhibitors and agomelatine |
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| US4843071A (en) * | 1986-12-05 | 1989-06-27 | Serotonin Industries Of Charleston | Method and composition for treating obesity, drug abuse, and narcolepsy |
| FR2658818B1 (en) | 1990-02-27 | 1993-12-31 | Adir Cie | NOVEL DERIVATIVES WITH NAPHTHALENIC STRUCTURE, PROCESS FOR THEIR PREPARATION AND THE PHARMACEUTICAL COMPOSITIONS CONTAINING THEM. |
| CA2306233A1 (en) * | 1997-10-17 | 1999-04-29 | Eli Lilly And Company | Potentiation of pharmaceuticals |
| FR2834890B1 (en) * | 2002-01-23 | 2004-02-27 | Servier Lab | ORODISPERSIBLE PHARMACEUTICAL COMPOSITION OF AGOMELATIN |
| CN100352506C (en) * | 2002-02-26 | 2007-12-05 | 奥索-麦克尼尔药品公司 | Co-therapy for the treatment of migraine comprising anticonvulsant derivatives and anti-migraine agents |
| JP2004292445A (en) * | 2003-03-11 | 2004-10-21 | Katsunori Nonogaki | Diabetic medicine |
| EP1675582A1 (en) * | 2003-09-12 | 2006-07-05 | Warner-Lambert Company LLC | Combination comprising an alpha-2-delta ligand and an ssri and/or snri for treatment of depression and anxiety disorders |
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| WO2005002562A1 (en) | 2003-07-04 | 2005-01-13 | H. Lundbeck A/S | The combination of a serotonin reuptake inhibitors and agomelatine |
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